Provider Demographics
NPI:1578759023
Name:DUARTE, DIOGENES FRANCISCO (MD)
Entity Type:Individual
Prefix:
First Name:DIOGENES
Middle Name:FRANCISCO
Last Name:DUARTE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 NW TURNER AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32055-8306
Mailing Address - Country:US
Mailing Address - Phone:386-754-1711
Mailing Address - Fax:386-754-1712
Practice Address - Street 1:320 NW TURNER AVE
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32055-8306
Practice Address - Country:US
Practice Address - Phone:386-754-1711
Practice Address - Fax:386-754-1712
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-19
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME87814207RS0012X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL01037OtherFL BLUE
FLP00253205OtherRR MEDICARE
H97901Medicare UPIN
FLU2575WMedicare PIN